STOP PAYING ATTENTION TO MICHAEL MOORE: To what extent does criticism, no matter how harsh or how justified, only build Moore up into a bigger celebrity? If one wanted to completely marginalize a public figure, how would one go about it? The answer is not that if you ignore him, he'll go away. Rather, I think the challenge is to ensure that liberals are the ones who are bashing Moore.

Thankfully, David Denby, the New Yorker's film critic, is making a good start. He writes that:

Michael Moore has teased and bullied his way to some brilliant highs in his career as a political entertainer, but he scrapes bottom in his new documentary, “Sicko.”...

Moore and the rescue workers (the other sick [passengers on the ship] having mysteriously disappeared) wander onto the streets of Havana and ask some guys playing dominoes if there’s a doctor nearby. They go to a pharmacy and then to a hospital, where the Americans are admitted and treated. Few people in Moore’s audience are likely to be displeased that they receive help from a Communist system. But what is the point of Moore’s fiction of a desperate, wandering quest for medicine on the streets, as if he hadn’t known in advance that Cuba has free health care? Why not tell us what really happened on the trip—for instance, what part Cuban officials played in receiving the American patients?

Well, it'll come out sooner or later. Besides, doing PR work for Castro is much less offensive than whitewashing Saddam Hussein's Iraq, a la Fahrenheit 9/11. (Remember the footage of joyful Iraqi children in a playground and the deafening silence about Saddam's occasional human rights violations?)

Denby later observes that:

Moore winds up treating the audience the same way that, he says, powerful people treat the weak in America—as dopes easily satisfied with fairy tales and bland reassurances. And since he doesn’t interview any of the countless Americans who have been mulling over ways to reform our [health care] system, we’re supposed to come away from “Sicko” believing that sane thinking on these issues is unknown here.

If you read the whole interview, you'll see that Denby reserves a certain affection for Moore, or at least for his politics. Denby concludes the review by noting that:

A shift to the left, or, at least, to the center, has overtaken Michael Moore, yielding an irony more striking than any he turns up: the changes in political consciousness that Moore himself has helped produce have rendered his latest film almost superfluous.

This makes it seem like Moore is the advocate of responsible politics, not the loudspeaker of the wing-nut left. To marginalize Moore, he must become someone who mainstream liberals are embarrassed to identify as one of their own. But that's no small task. The extremes often generate a devoted audience. And then the rest of the party either pays lip service or avoids unnecessary conflicts with the base. (It's the same with conservatives, of course.)

Ultimately, I suspect that Moore may have to be the author of his own political demise. He needs to insult America in a way that makes any association with him taboo. For example, a bad enough cheapshot at American soldiers might do the trick. Sort of like John Kerry's remark about them all being dropouts, but worse.

You could say that it's mean-spirited to strategize about how to marginalize anyone other than the KKK or some other hate group. I'd respond that anyone who whitewashes a murderous dictatorship and generally debases our standards of public debate deserves exactly that. The same goes for conservative wing-nuts as well as liberals. I just pay more attention to the latter, since the conservative ones rarely get much positive coverage in the publications I read or much praise from the liberals in my Ivy League demograpic.

what a couple of punks. On health care, leave the Cuban government alone. I was seen by a doctor in Cuba within 5 minutes of making the appointment. It was a Friday night, and seeing foreigners or Cubans under those circumstances was not atypical.

the problem with Cuba's health system is not in their commitment to nor understanding of the word 'care.'

But David, Kerry's wasn't taking a cheapshot at soldiers at all, as you know well. It was a botched joke about Bush.

On sicko, I understand your vitriol. I am not sure that the lack of sophisticated assessment of the medical system is the appropriate critique though. Check out Ezra's review. Like his position or not, he knows the health care debate, and participates in it in the very way you call for - reasoned argument. His review is at the link below,but in particular reference to the style Moore uses, he says this:

"Contrary to its billing, Sicko is not a movie about health care policy. It does not spend time examining inefficiencies, or incentive structures, or public-private hybrids. It does not offer a methodologically rigorous cross-national comparison of health care systems. (Its portrayal of Cuba is, indeed, absurdly rosy.) That's not its point."

"Its point, of course, is to arouse passion, to force debate, and on that, it succeeds. A few hours before, I'd been on Larry Kudlow's TV show, ostensibly to discuss health care and Moore's new movie. "I hate it," barked Kudlow. "Michael Moore's movie Sicko calls for socialized medicine." He hadn't seen it, of course, but felt perfectly comfortable assuming, and judging, its arguments."

"The film is more radical, and more troubling, than he'd even imagined. Moore's movie is only superficially about health care. It uses the subject -- and also sick days, and vacations, and child care, and maternal support policies -- as a way to critique unthinking American exceptionalism, to challenge the tautology that states that the way we do things is the best way to do things because … it's the way we do things. The particulars of the account all add up to the larger question: Is the America we live in the America we think we live in, and the America we want to live in?"

I would also add, that unlike F-911, the reviews suggest that this movie may very well be distasteful, but is relatively non-partisan. It is getting positive and negative reviews from across the spectrum. And, most who have seen it seem to think that it is going to stir significant debate about the inefficiencies in the private delivery of health care. Whatever one believes the solution is, surely pointing out the glaring problems of the current system is good for the public debate?

Taylor, I should've been more clear about Kerry's comment about the troops. It was a botched joke, not an intentional cheapshot, as you point out.

With regard to your more central point, that illustrating the flaws of the current system and generating passion for reform is a net positive, that is true. Yet the way in which Moore does it makes him a pernicious influence. His distortions just generate anger and ignorance.

Moore was the editor of Mother Jones for a short time 20 years ago. At the time Paul Berman had been dispatched to Nicaragua to report on the progress of the Sandinistas. Berman's article was highly critical of the way Ortega and co. were abridging rights.Moore refused to run the piece complaining that Berman was helping Reagan. (His refusal to run the piece led to his dismissal.)Ironically, a few years ago he claimed that Jeb Bush was putting pressure on Disney not to distribute F9/11. The charge was false but that didn't stop Moore's supporters (e.g. NYT editorial page) from claiming that the government was censoring Moore.Edward Jay Epstein has shown how this was just a part of a marketing ploy by Moore.From these experiences Moore has shown himself to be a censor and a liar. And yet he's still lionized by many for telling uncomfortable truths.

oSoccor dad notes "Moore has shown himself to be a censor and a liar. And yet he's still lionized by many for telling uncomfortable truths."

Which would be ironic, were it not for the censorial thought control Dems already practice through PC and multicult, abandonong democracy for Iraqi's, and now, in advocating a born-again "Fairness Doctrine."

Instead it's become predictable, and that's why I became an ex-Dygnrrkjlem over 10 years ago, and I wonder at those who remain. Why do they sanction evil?

As long as you insist on repeating the lie about Kerry's flubbed joke about Bush, your credibility on all your other points is completely compromised. Let me guess, Gore said he invented the internet too, right?

I think that most politicians are avoiding Moore on this film because millions of voters, mostly seniors, have to deal with this same system every day to get their Medicare and Medicaid benefits fulfilled.

Nobody really expects this to get any better no matter who is paying the bills.

As for the Cubans, warm bodies have never been a problem, but as for medicine, it is harder to find than a virgin at a bordello. The only thing harder to find in Cuba than medicine is a roll of toilet paper. It's strictly BYOR (bring your own roll).

My view of Mr. Moore will forever be shaped by a speech I happened to see on a public access channel a few weeks after 9/11 as I was flipping through the channels one afternoon. There was Mr. Moore calling the war in Afghanistan a "phony war". It reminded me about what Orwell wrote about certain pacifists actually being fascist supporters. From "Roger & Me" onward (he actually was able to interview GM's chairman), Mr. Moore has engaged in a systematic process of misrepresentation and deceit that in all instances have the effect of presenting the US in the worst possible light. I also find some of the comments laughable. Lies are not excused in the name of "arousing passion". By that standard Stalinist and Nazi propaganda films were must see viewing. Because when you don't even try to get the facts right, when you try to prove points by selective anecdotes and staged scenes and other manipulative techniques, all you are left with is propaganda. And as to the genius who attacks critics of Cuba's vaunted health care system as "punks", I can also think of some abusive terms too, such as gullible moron.

US News and World Report did a story in September, 2006 called "Behind the Baby Count" that effectively debunked using infant mortality as a means of attacking the US health care system. It pointed out that the US uses a much more stringent criteria than other nations, that other nations don't provide accurate numbers (Cuba anyone?), and that severe prematurity, deformity, or SIDS are the primary causes of infant mortality in the US and arise from factors which have nothing to do with the qulaity of natal treatment. It further notes that when involving treatable conditions the US is not exceeded by any other nation in preventing infant mortality. So I guess before making a snarky reply maybe taking a few minutes to actually research the issue would be better.

This makes it seem like Moore is the advocate of responsible politics, not the loudspeaker of the wing-nut left.

Which is, however, true-- he almost does sound like the advocate of responsible politics. The brilliance of "Bowling for Columbine" was how it evolved from starting out as almost saying, "the problem with America is guns" to saying, "the real problem is that we're all incredibly fearful and paranoid" (as any trip to the airport and their insistence on plastic baggies will tell you). His commentary is almost mainstream. Discussion of the problems of America's health care system are pedestrian, mainstream complaints. It is the lunatic-right extremists who are claiming "HSAs and running a mini-insurance company out of your own home are the solution!" that put themselves beyond the pale of rational discourse.

I should've been more clear about Kerry's comment about the troops.

It's that that you should have been more clear, it's that you shouldn't have been dishonest when you knew otherwise.

Just remember, there are more Americans trying to get into Sweden than Swedes trying to get into America.

The best way to measure a health care system is to ask the people who use it. Canada, most European countries (even the UK!)that have socialized health care all have higher satisfaction ratings from the actual patients than the US. By a lot. As much as we hear about long lines, and other phoney knocks on socialized health care, the people in those countries are overwhelmingly happy to have it, and would not trade it with the US system. Yes, there are rich folk who like to have things that the regular folks can't have (otherwise, what good is being rich?), so let them get the gold-plated stethescopes. As long as the regular working folk can see a doctor when they need to.

Last question: Why does health care in the US, which is inferior to care in Sweden, Denmark, Canada, etc (by any ranking or poll you choose) cost so much more than in the countries that have socialized medicine? I thought the "free market" was supposed to be good for consumers.

presumably also, socialised health care systems benefit from the fact that many of the world's breakthrough medicines are produced by 'big pharma' where it is profitable to do so, the capitalist United States.

Michael Moore is a proven liar on matters great and small, who treated Saddam's regime as an innocent sovereign government and panders to the most witless and ignorant forms of anti-Americanism on the market. So having tried his past productions, I might give his latest film a miss.

A report by the General Accounting Office concludes that current patent law discourages drug companies from developing new drugs by allowing them to make excessive profits through minor changes to existing pharmaceuticals. While pharmaceutical research and development expenses have increased by 147% since 1993, applications for approval of "new molecular entity" (NME) drugs, or drugs which differ significantly from others already on the market, have risen only 7%. According to the report, the majority of newly developed medicines are so-called "me-too" drugs, which are substantially similar to existing drugs, are less risky than NMEs drugs to develop, and which "offer little in the way of therapeutic breakthroughs."

Under existing patent law, these "me-too" drugs can receive new patents separate from the already existing drugs they are based on, allowing drug companies to make substantial profits without signficantly enhancing the quality of drugs available on the market. According to the report, "the ability of drug manufacturers to easily obtain patents for minor changes to products, or to receive patent exclusivity for new uses of existing products, have reduced incentives to develop new drugs."

One surveyfound that taxpayer-funded research developed 15 of the 21 mostimportant drugs introduced between 1965 and 1992. And these aren't jokepharmaceuticals:

A study of the 21 drugs introducedbetween 1965 and 1992 that were considered by experts to have had the highest therapeutic impact on society found that public funding of research was instrumental in the development of 15 of the 21 drugs (71percent). Three-captopril (Capoten), fluoxetine (Prozac), and acyclovir(Zovirax)-had more than $1 billion in sales in 1994 and 1995. Inaddition to these drugs, other members of the group of 21 drugs,including AZT, acyclovir, fluconazole (Diflucan), foscarnet (Foscavir),and ketoconazole (Nizoral), had NIH funding and research to help inclinical trials.

Another study, this one from 1990, looked at 32 drugs on themarket and concluded 60 percent would've never been developed withoutpublic funds. Yet another"traced more than 45,000 references from U.S. patents to the underlyingresearch papers, and tabulated both the institutional and financialorigins of the cited science. We found that more than 70 percent of the scientific papers cited on the front pages of U.S. Industry patents came from public science -- science performed at universities,government labs, and other public agencies."

Pharmaceutical companies don't develop all their drugs. Theyspend a lot of time buying, patenting, and bringing to market advancesmade in the public sector through NIH grants and university research.If you're curious as to how this works, take a lookat the cancer drug Taxol. Discovered by the NIH and licensed toBristol-Meyers-Squibb, Taxol is sold for $20,000, costs $1,000 toproduce, and the NIH gets .5 percent of the royalties. Thepharmaceutical industry was damn innovative, to be sure, but not in thedevelopment of this drug -- only in the selling of it.

Essentially they are good marketers. It's worth noting that the Portuguese word for advertising is propaganda . . .

of course you are right that there are major non-American pharmaceutical companies too.

I am simply pointing out that an awful lot of the top 30 or so companies are American, and these have made decisive contributions to developing medicine for cancer, AIDs and heart disease.

On the issue of socialised medicine, I agree that the state has an important role to play in providing for those who can't look after themselves, and would favour more of a mixed system (like Australia's).

But my point here is that 'Big Pharma' must help non-American socialised systems.

my point here is that 'Big Pharma' must help non-American socialised systems.

I'm not sure what you're arguing here. That 'Big Pharma' needs the American citizens (who pay more per capita for healthcare than elsewhere) to pay for development of drugs?

[I often wonder why no one actually wants to touch on the fact that 44 million Americans are uninsured. Why do we keep need to diverting to arguments like 'US Big Pharma is competitive', etc etc?]

It is all about trade-offs, of course. Healthcare is tricky because there is no upper limit to expenditure. If you (for example) argue that Big Pharma wouldn't work as well if the US had a socialized system (cheaper drugs, more tax, etc), this is of course a trade-off. Is it worth it to not save 10 insured cancer patients with experimental drugs vs. (say) making sure 10000 people could get free treatment for broken arms? Who knows - but perhaps one should start thinking about it like that. Probably for another post...

I agree with you about a two-tier system. There are plenty of ways to set this up.

I assume Moore doesn't point out that almost every country with a free health care system has tremendous economic problems?

I don't know what you would call "tremendous economic problems". In Canada, we have a positive balance of trade overall (we sell more than we buy), unlike the United States, which has run in the red since Ronald Reagan took office. In Canada, we have kept our public finances in the black, unlike the United States, which has run close to half a trillion in the red each year pretty much for the last six years.

Of course, we have our problems. Some of us have felt the pain of having investments in the US since your dollar cratered (you do know the US dollar has lost close to a third of its value against the Loonie since your current president took office, right?) And yes, the new strength of our currency has cut into our export sales a bit, although not enough to put us in the red.

But of course none of these problems has anything to do with our system of socialized medicine. If anything, by keeping our health-care costs down and our economy flexible at a personal level, the Canadian system makes us freer and more economically competitive. Certainly, big employers like Ford, GM, and others seem to think so.

This brings us to one of the basic issues in the debate: the madness that leads so many Americans to confuse a system based on a medieval craft guild system for "free enterprise". Milton Friedman made the case for a truly free enterprise medical system; it might work and it might not, but it looks nothing like the system now in existence in the United States.